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Clinical information

Diagnosis:

Small cell naevoid melanoma

Comments:

Small cell naevoid melanomas are sometimes underdiagnosed because of the small, naevoid cell type and the sometimes regular overall (verrucous or dome-shaped) appearance. Some are bulky, esepcially the ones arising in large congenital naevi, they display considerable mitotic activity and there may be subtle but abrupt variations in cellular features or lesional architecture. Ascent may or may not be present. These melanomas sometimes affect children; such childhood lesions appear to be most common on the scalp.

Note the deeptly intented, convoluted and grooved small nuclei and areas of this melanoma (see last micrograph of the panel below). It differs from the larger van vesicular, or dark and lymphocyte-like, or elongated nuclei seen in the large majority of melanocytic naevi. Although I have not studied this systematically and am not aware of any study on this in the literature, it is my impression that this nuclear type is quite common in small cell naevoid melanomas. If one sees such nuclei, I believe it is wise to think twice (i.e., do levels, hunt for other possible subtle indicators of malignancy, ask for help) before rendering a diagnosis of naevus.

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Dear {friend_name},
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I believe this website may be of interest to you. It is an Open Educational Resource, containing a large collection of digitized histologic slides with explanatory films and other materials, aimed at surgical pathologists, dermatopathologist and pathologists in training. This site is entirely based on consultation materials of professor Wolter Mooi, VU University Amsterdam, and can be used free of charge.
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